True Midwifery Is…?
What does it mean to be a midwife? What is true midwifery? In Episode 7 Jenny Lee returns and must maneuver the rigid routines of the London hospital maternity ward. Sister Morgan, the head midwife makes it very clear that midwifery at The London is not like the District Midwifery Jenny has known. So Jenny struggles to bring her vision of midwifery to the hospital. She listens and empathizes with the young woman struggling with her fear from a previous stillbirth. She finds ways to reassure the woman and gain her trust. Finally, she assesses the new mother’s most important need. She finds a way to circumvent hospital policy and finally place the newborn into the desperate mother’s arms. She describes her brand of midwifery to Sister Morgan this way, ” I need to care. I can’t ration it or turn it into an efficiency. That will never be my way.”
In our practice at Henry Ford Hospital in Detroit, we are challenged daily to bring our vision of midwifery to our patients. Many have physical risk factors, social issues or diverse cultural expectations which impact the care we give. The births we attend are not all dim lights, soft music and natural birth experiences commonly associated with midwife births. As members of a multidisciplinary team in a very busy obstetrical unit our practice has taken on additional responsibilities which often preclude sitting with a patient through her labor as is a traditional role of midwife.
We had a member of our practice leave a few months ago to go to a different practice where she felt she could do “true midwifery.” She rankled us a bit with that but just as Jenny expressed her respect for what the midwives do in the hospital we understood her need to seek out her vision of what midwifery means to her and wished her well in her journey.
I have been involved in discussions over the years with midwives who feel that midwifery cannot be practiced in a hospital setting. We are med(ical)-wives or merely physician extenders, they may say. But every chance my partners and I get we listen, empathize and assess what women truly need. As the experts in normal birth we continue to model practices which support the birth process and challenge the status quo, teaching residents, students and staff. We make a difference to the women whose lives we touch and to the obstetrical culture of our institution. Do we practice true midwifery? You bet your Pinard we do.
This episode was brimming with heavy emotions. One fan described it as a six tissue episode. Indeed. I hope for a bit of lightness in the next episode but it won’t change the fact that next week brings us to the final episode of this season! Crazy. Keep plenty of tissues handy, folks.
Deborah McBain (CNM, MS, BSN, RN) is a nurse-midwife who has practiced in Metro Detroit for nearly 20 years. McBain received her Bachelor’s Degree in Nursing Science from Wayne State University-Detroit, Master’s Degree from the Case Western University-Cleveland and midwifery education through Frontier Nursing Service.
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